1.Evaluation of titanium-prepared platelet-rich fibrin incorporated with amoxiclav, metronidazole, and neem gel on bone regeneration in Wistar rats: a pilot study
Shiva Shankar GUMMALURI ; Trinath Kishore DAMERA ; Viswa Chandra RAMPALLI ; Anusha BODDEDA ; Naveen Vital Kumar GIDIJALA ; Ramanarayana BOYAPATI ; Kaarthikeyan GURUMOORTHY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2026;52(2):80-93
Objectives:
Titanium platelet-rich fibrin (T-PRF) usage as sustained drug delivery system (SDDS) has been recently started. Hence present study aimed to evaluate hard tissue regenerative efficacy of T-PRF clots incorporated with amoxiclav (AMX)/metronidazole (MET)eem (NE) gels individually in osseous defects created in Wistar rats.
Materials and Methods:
In this in vivo animal model trial, 12 female Wistar rats were procured and subjected to ligature induced periodontitis.Bone defects were created and incorporated with T-PRF plain, T-PRF clots+AMX/MET/NE gels individually. Rats were sacrificed after 2 months and checked under light microscopy and micro (µ)-computed tomography analysis for bone regeneration. Frequency distribution percentages, chi-square test, ANOVA and un-paired t-test were used for conducting the statistical analysis.
Results:
Inflammatory response was reported in T-PRF+MET Group followed by AMX Group and no inflammatory response was recorded for T-PRF plain with statistical significance (P=0.008), for mineralized and un-mineralized bone formation there was no significant difference (P=0.133). Mean comparisons of bone density there was no significant difference (P=0.545) among all (AMX=551.00±18.68, MET=578.00±18.25, NE=569.00±24.58, T-PRF plain=507.67±118.50). For gene expression significantly (P<0.001) higher alkaline phosphatase and bone morphogenetic protein-2 levels were recorded for T-PRF+NE Group (7.60±3.04, 10.85±1.28) followed by MET (4.65±1.52, 4.64±0.45)>AMX (2.47±0.84, 1.89±0.18)>T-PRF plain (1.00±0.00, 1.00±0.00).
Conclusion
Research results showed that T-PRF can be a SDDS and addition of antibiotics or herbal extract didn’t alter the hard tissue healing property of T-PRF and resulted in new bone formation.
2.Evaluating the antimicrobial efficacy, growth factor release drug kinetics of titanium platelet-rich fibrin loaded with amoxiclav, metronidazole and neem gel: an in vitro study
Shiva Shankar GUMMALURI ; Trinath Kishore DAMERA ; Viswa Chandra RAMPALLI ; Ramanarayana BOYAPATI ; Kaarthikeyan GURUMOORTHY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2025;51(6):369-383
Objectives:
The use of titanium platelet-rich fibrin (T-PRF) as a sustained drug delivery system (SDDS) has been limited. Hence present study aimed to evaluate the antimicrobial efficacy, drug kinetics and growth factor release of T-PRF injected with amoxicillin+clavulanic acid (amoxiclav gel), metronidazole (MTZ) and neem (NE) gels separately.
Materials and Methods:
12 Healthy volunteers were recruited for this in vitro analysis. Drug kinetics were monitored at 0, 2, 24, 48, and 72 hours.Antimicrobial efficacy was assessed at 48 hours post inoculation in culture plates and growth factor release was measured at 3, 7 and 10 days. Kruskal– Wallis test, Dunn’s Post hoc test, Bonferroni’s correction and Mann–Whitney U test were used to compare the drug release over time frames, inhibition zone diameters (IZDs) and growth factor release were expressed in (mean and standard deviations) millimetres, pico g/mL and nano g/mL.
Results:
In terms of drug kinetics, both T-PRF clots and collagen sponges when injected with antibiotic/ herbal gels individually there was a sustained drug release up to 72 hours and there was a greater release observed in collagen sponge. IZDs were recorded for T-PRF injected with amoxiclav/MTZ/ NE gel for anti-microbial efficacy. Growth factor release was also observed for T-PRF plain and T-PRF injected with gels, with levels were numerically higher in T-PRF plain.
Conclusion
Within the limitations of the study T-PRF demonstrated sustained drug release with superior antibacterial activity. Growth factor release was not compromised, aiding in the preservation of regenerative capacity. Therefore, T-PRF can be used as a SDDS.

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